<!DOCTYPE html>
<html>
<head lang="en">
    <meta charset="UTF-8">
    <title>弹出框</title>
</head>
<link rel="stylesheet" href="alert.css" />
<script type="text/javascript"src="avalon.js"></script>
<body>
<div class="print_moneySlip">
    <div class="print_moneySlip_main">
        <div class="consult_title">上传打款凭条</div>
        <div class="use_item">
            <label>打款人姓名</label>
            <input  type="text" placeholder="请输入打款人姓名"  />
        </div>
        <div class="use_item">
            <label>身份证号</label>
            <input  type="text" placeholder="请输入打款人身份证号" />
        </div>
        <div class="use_item">
            <label>银行卡号</label>
            <input  type="text" placeholder="请输入打款人银行卡号" />
        </div>
        <div class="use_item">
            <label>银行名称</label>
            <input  type="text" placeholder="请输入银行名称" />
        </div>
        <div class="use_item">
            <label>支行名称</label>
            <input  type="text" placeholder="请输入支行名称" />
        </div>
        <div class="use_item">
            <label>打款金额(万元)</label>
            <input  type="text" placeholder="请输入打款金额" />
        </div>
        <div class="use_item"style="padding-bottom: 15px;border-bottom: dashed 1px #A6B0BC;">
            <label>备注</label>
            <input  type="text" placeholder="请输入您的备注信息（限20字）" />
        </div>
        <div class="upImg">
            <img id="img" style="width: 100px" src="add_3.png" ng-click="onSelectImg()"/>
        </div>
        <button ms-click="submitOnlineConsult()">确认提交</button>
    </div>
    <div class="close">&times;</div>
</div>
</body>
</html>